Provider Demographics
NPI:1568957769
Name:WOLVERTON, CAROLINE M (DO)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:M
Last Name:WOLVERTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:E
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 GULF BREEZE PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-4851
Mailing Address - Country:US
Mailing Address - Phone:850-916-3680
Mailing Address - Fax:
Practice Address - Street 1:1200 GULF BREEZE PKWY STE B
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-4851
Practice Address - Country:US
Practice Address - Phone:850-916-3680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16583207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine